Use of herbal medicine during pregnancy and associated factors among pregnant women with access to public healthcare in west Shewa zone, Central Ethiopia: sequential mixed-method study

OBJECTIVE

This study was aimed at assessing the prevalence of herbal drug use among pregnant women with access to modern medicine and associated factors in public health facilities in the west Shewa zone, Oromia regional state, Ethiopia.

DESIGN

A sequential mixed-method study approach was carried out among pregnant women and other stakeholders.

SETTING

This study was conducted at public health facilities, including 3 public hospitals and 20 health centres, in the west Shewa zone of Ethiopia.

PARTICIPANTS

A systematically selected sample of 411 pregnant women was participated in the quantitative study. For the qualitative method, focus group discussions and in-depth interviews were conducted among pregnant women attending antenatal care and key informants using an interview guide until data saturation was achieved.

PRIMARY OUTCOME

For outcome variables, the respondents were asked if they used any herbal medicine during their current pregnancy. It was then recorded as 0=no and 1=yes.

RESULTS

The prevalence of herbal medicines was found to be 19.7%. The most commonly used herbal medicines were Zingiber officinale, Ocimum gratissimum, Eucalyptus globules, Allium sativum and Rutacha lepensis. Herbal medicine use during pregnancy was significantly associated with older maternal age (adjusted OR (AOR) 2.4, 95% CI 1.2 to 5.1), urban residence (AOR 2.3, 95% CI 1.3 to 3.7) and second trimester of pregnancy (AOR 2.3, 95% CI 1.3 to 4.5).

CONCLUSIONS

In this study, one in five pregnant women uses herbal medicine, which is relatively low. Sociodemographic factors and the duration of pregnancy affected the utilisation of herbal drugs during pregnancy. The most common herbals used by pregnant women were intended to treat minor disorders of pregnancy and medical disorders such as hypertension.

Intention to Leave Nursing Profession and Its Associated Factors Among Nurses: A Facility Based Cross-Sectional Study

Nurses' intention of leaving their profession is the main challenge for healthcare and hospital administrators in many countries. It has significant impact on the performance, stability and productivity of health facilities. However, there is limited evidence on the nurses' intention to leave their profession and associated factors among nurses in developing countries including Ethiopia. This study was aimed to assess intention to leave nursing profession and its associated factors among nurses working in West Shoa Zone public Hospitals, Oromia region, Central Ethiopia, 2020. Institution based cross-sectional study was conducted among 393 nurses working in West Shoa zone public hospitals, Ethiopia from May 1 to 30, 2020. Simple random sampling technique was used to select the study participants. Structured self- administered questionnaire was used to collect data. Data were cleaned and entered into Epi-data version 3.1 then exported to SPSS version 25 for analysis. Descriptive statistics such as frequency mean and standard deviation was computed to describe variables of the study. All covariates that were significant at P value <0.25 in bivariate logistic regression analysis were considered for further multivariable logistic regression analysis. Backward stepwise logistic regression model was fitted, crude ratio and odds ratio were calculated for factors at 95% confidence interval (CI). Level of statistical significance was declared at P value <0.05. In this study, the overall nurses' intention to leave nursing profession was 61.3% [95% CI (56.5%, 66.2%)]. Nurses' educational status, age, working experience, working position, professional commitment, job stress, job satisfaction and organizational factor were significantly associated with nurses' intention to leave their profession. The overall nurses' intention to leave their profession was high. Reducing this level of leaving intention needs collaborative intervention related to factors like safety of working environment, job related stress, job satisfaction, professional commitment and education opportunities which are a big homework for managers on health sectors of West Shoa zone public Hospitals and higher level health sector managers.

Level of Patient Health Literacy and Associated Factors Among Adult Admitted Patients at Public Hospitals of West Shoa Oromia, Ethiopia

BACKGROUND

Health literacy is a capacity of individual to gain knowledge that helps to use health information in different levels as needed for self-management and to communicate with health providers. Health literacy has a significant impact on patient health outcomes. The aim of this study was to assess level of patient health literacy and associated factors among adult admitted patients at public hospitals of West Shoa zone, Oromia, Ethiopia.

METHODS

A cross-sectional, quantitative study was carried out among adult admitted patients at public hospitals of West Shoa Oromia, Ethiopia. An interviewer-administered Health Literacy Questionnaire (HLQ) instrument tool was used to assess patients' health literacy. All statistical analysis were performed using SPSS for windows program version 21.

RESULTS

A total of 403 patients participated in this study. Majority of the participants were males 235 (58.3%) and aged 40-59 years (n = 164, 40.7%). Overall, 59.1% (n = 238) of the participants have high health literacy. Those respondents who are above grade 12 (tertiary) were 2.45 times more likely to have high health literacy (AOR = 2.45, 95% CI: 1.21, 4.98) compared to those respondents not able to read and write . Participants who had age greater or equal to sixty were 65% less likely to have high health literacy (AOR: 0.35, 95% CI: 0.18, 0.70).

CONCLUSION AND RECOMMENDATION

Forty percent of the participants have low health literacy. Age and education are significant factors in health literacy. Ethiopian ministry of health, Oromia regional health bureau, West shoa zonal office and healthcare professionals have to provide an intervention in enhancing the level of health literacy by mass media and written material.

Patient Preferences in Shared Decision Making During Healthcare and Associated Factors Among Adult Admitted Patients at Public Hospitals of West Shoa Oromia, Ethiopia

BACKGROUND

Patient preferences mean the choices of individuals to make decisions about health and medical treatment by using their own experiences, beliefs, and values. The aim of this study was to assess patient preferences in shared decision making during healthcare and associated factors among adult admitted patients at public hospitals of West Shoa Oromia, Ethiopia.

METHODS

A cross-sectional study was carried out among adult admitted patients at public hospitals of West Shoa Oromia, Ethiopia. An interviewer-administered with the Control Preference Scale questionnaire instrument tool was used to assess patient preferences in shared decision making. All statistical analysis was performed using SPSS for windows program version 21.

RESULTS

A total of 403 respondents participated. Out of the total respondents, 168 (41.7%) were females. Overall, 64.8% (n=261) of the respondents prefer a collaborative role in shared decision making. Age (AOR 4.11, 95% CI 2.21-7.64), marital status (AOR 0.37, 95% CI 0.20-0.68), and education level (AOR 2.45, 95% CI 1.13-4.87) are significant in patient preference in shared decision making.

CONCLUSION AND RECOMMENDATION

More than half of respondents 261 (64.8%) prefer shared decision making in a collaborative role with healthcare providers. Age, marital status, and level of education are factors associated with the patient preferences in shared decision making. The Ethiopian ministry of health should work on policy of shared decision making. Healthcare providers have to consider patients in shared decision making.

Listeria Species Occurrence and Associated Factors and Antibiogram of Listeria monocytogenes in Beef at Abattoirs, Butchers, and Restaurants in Ambo and Holeta in Ethiopia

PURPOSE

Listeriosis is one of the globally distributed foodborne diseases with the highest fatality rate. The objectives of this study were to isolate and identify Listeria species, assess factors for contamination of beef, and antibiogram of Listeria monocytogenes in Ambo and Holeta towns, Central Ethiopia.

MATERIALS AND METHODS

A total of 450 meat samples were collected from abattoirs (n=150), butchers (n=150), and restaurants (n=150) for isolation and identification of Listeria species. Logistic regression analysis was used to assess the association between the occurrence of Listeria species in meat and potential risk factors. The antimicrobial susceptibility test was done using the Kirby Bauer test.

RESULTS

The overall occurrence of Listeria species in Ambo and Holeta towns was 28.4% (128/450; 95% confidence interval [CI]: 24.3-32.9%). The isolation rate of Listeria monocytogenes was 4.4%, Listeria ivanovii 2.2%, Listeria seeligeri 1.8%, Listeria welshimeri 3.8%, Listeria innocua 6.2%, and Listeria grayi 10.2%. The probability of contamination of meat in butchers and restaurants was higher in Holeta than Ambo [OR=3.4; 95%; p=0.001], in dry than wet season [OR=5.2; p=0.009], and where the hygiene of cutting boards was poor (OR=7.7; p=0.008). Of the 20 Listeria monocytogenes isolates, 80%, 70%, 60%, and 55% were resistant to oxacillin, amikacin, and nalidixic acid, chloramphenicol, and tetracycline, respectively. The Listeria monocytogenes isolates were 95%, 90%, and 85% susceptible to amoxicillin, vancomycin, and clindamycin, respectively. About 95% of Listeria monocytogenes isolates were multidrug-resistant. One isolate (5%) had developed resistance to 10 classes of antimicrobial drugs.

CONCLUSION

Listeria species are widespread and study towns, season, and hygiene of cutting boards are independent predictors of isolation of Listeria species. Multidrug resistance among Listeria monocytogenes was very high. Therefore, adequate cooking of meat, regular training of beef handlers, prudent use of drugs, and further molecular studies on Listeria species are important.

Maternal health care services utilization amidstCOVID-19 pandemic in West Shoa zone, central Ethiopia

The novel coronavirus (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Despite strong efforts that have been taking place to control the pandemic globally, the virus is on the rise in many countries. Hence, this study assessed the maternal health care services utilization amidst the COVID-19 pandemic in West Shoa zone, Central Ethiopia. A community-based cross-sectional study was conducted among 844 pregnant women or those who gave birth in the last 6 months before the study. A multi-stage sampling technique was used to select the study participants. The data were collected through face-to-face interviews using a semi-structured questionnaire. Logistic regressions were performed to identify the presence of significant associations, and an adjusted odds ratio with 95%CI was employed for the strength and directions of association between the independent and outcome variables. A P-value of <0.05 was used to declare statistical significance. The prevalence of maternal health service utilization during the COVID-19 pandemic was 64.8%. The odds of maternal health service utilization was higher among mothers who had primary (AOR = 2.16, 95%CI: 1.29-3.60), secondary (AOR = 1.97, 95%CI: 1.13-3.44), and college and above education (AOR = 2.89, 95%CI: 1.34-6.22) than those who could not read and write. Besides, mothers who did travel 30-60 minutes (AOR = 0.37, 95%CI: 0.23-0.59) and 60-90minutes (AOR = 0.10, 95%CI: 0.05-0.19) to reach the health facility had a lower odds of maternal health service utilization than those who did travel <30 minutes. Moreover, mothers who earn 1000-2000 (AOR = 3.10, 95%CI: 1.73-5.55) and > 2000 birrs (AOR = 2.66 95%CI: 1.52-4.64) had higher odds of maternal health service utilization than those who earn <500 birrs. Similarly, the odds of utilizing maternal health service were higher among mothers who did not fear COVID-19 infection (AOR = 2.79, 95%CI: 1.85-4.20), who had not had to request permission from husband to visit the health facility (AOR = 7.24, 95%CI: 2.65-19.75), who had practicedCOVID-19 prevention measure (AOR = 5.82, 95%CI: 3.87-8.75), and used face mask (AOR = 2.06, 95% CI: 1.28-3.31) than their counterpart. Empowering mothers and creating awareness on COVID-19 preventionis recommended to improve maternal health service utilization during the COVID-19 pandemic.

COVID-19-Induced Anxiety and Associated Factors Among Urban Residents in West Shewa Zone, Central Ethiopia, 2020

BACKGROUND

The COVID-19 pandemic affects the public overall psychological status including anxiety. Assessing the perceived risk and preventive behaviors and COVID-19-induced anxiety of every individual is crucial to be more effective in handling the outbreak.

PURPOSE

This study intends to determine the status of perceived risk, preventive behavior, and induced anxiety regarding COVID-19 among urban residents in Ethiopia.

METHODS

In this research a population-based, cross-sectional design was employed among 801 urban residents in West Shewa Zone, Ethiopia from June to October 2020. COVID-19 Induced Anxiety Scale (CIAS) was used, with CIAS score ≥80% taken as having anxiety. A Preventive Behavior towards COVID-19 Scale (PBCS) was used to measure the level of protective behavior. The data were gathered using CS Entry and analyzed with SPSS version 23.0. Basic descriptive analysis was conducted, and binary logistic regression analysis was carried out to determine the predictors associated with anxiety.

RESULTS

Most of the study population, 716 (89.4%), had moderate risk perception, and around 497 (62.0%) of them had moderate preventive behavior against the pandemic. The proportion of COVID-19-induced anxiety disorder was found to be 18.1%. The identified predictors associated with COVID-induced anxiety were: being widowed (AOR=3.5; 95% CI: 1.7-7.6), lacking formal education (AOR=1.9; 95% CI: 1.3-3.3), having history of psychoactive substance use (AOR=3.0; 95% CI: 1.6-5.8), high protective behavior (AOR=2.2; 95% CI:1.5-3.3), low perceived risk (OR=3.7; 95% CI: 1.5-12.4), and family history of mental illness (AOR=1.6; 95% CI:0.7-3.8).

CONCLUSION AND RECOMMENDATION

COVID-19-induced anxiety prevalence was 18.1%. Risk perception regarding COVID was moderate. However, only 38.0% of the population had high preventive behavior against the pandemic. Hence, it is important to provide the continuous public health education necessary to promote preventive measures and minimize risky behaviors. Basic psychosocial help should be also provided for individuals suffering with COVID-19-induced anxiety.

Knowledge, Utilization and Associated Factors of Postpartum Family Planning Among Women Who Had Delivered a Baby in the Past Year in Oromia Regional State, Ethiopia

BACKGROUND

Globally, 95% of women wants to avoid pregnancy for at least two years after giving birth, but 70% of them are not using contraception; majority of them were from developing countries. Postpartum family planning (PPFP) enables families to avoid unplanned pregnancies following 12 months after childbirth. Different studies in Ethiopia showed that the majority of postpartum women do not use PPFP. Moreover, the level of PPFP knowledge and utilization in West Shewa, Oromia region of Ethiopia is unclear.

PURPOSE

This study aimed to assess the knowledge, utilization and associated factors of postpartum family planning (PPFP) Oromia regional state, Ethiopia.

METHODS

A community-based cross-sectional study was conducted in Ambo town, West Shewa Zone of Oromia regional state from April 01 to July 30, 2019. A sample of 367 postnatal women participated in the study. An interview administered questionnaire was used to collect the data and the collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Study participants' characteristics were described using frequency and percentage. Bivariate and multivariate logistic regression was carried out to identify the associated factors with the outcome variables.

RESULTS

A total of 354 women were participated in the study making a response rate of 96.4%. About 249 (70.3%) of the respondents had good knowledge about PPFP and 144 (40.7%) had utilized PPFP services. Higher education level [AOR= 3.4, 95% CI: 1.3-6.9], history of family planning utilization [AOR= 2.8, 95% CI: 2.1-4.4] and having ANC follow-up [AOR=2.1, 95% CI: 1.1-4.0] had showed a positive association with knowledge of PPFP. Meanwhile, knowledge of PPFP [AOR=2.1, 95% CI: 1.6-3.1], a grand multi-para women [AOR=1.7, 95% CI (1.3-3.6)] and received routine PNC service [AOR=2.5, 95% CI: 1.3-5.9] were associated with the utilization of PPFP.

CONCLUSION AND RECOMMENDATION

Although the majority of the women knew about PPFP, more than half of them did not utilize PPFP. Due emphasis should be given to improve the utilization of PPFP.

Mother's satisfaction with the existing labor and delivery care services at public health facilities in West Shewa zone, Oromia region, Ethiopia

BACKGROUND

Mothers' satisfaction with care during childbirth is indicators of the quality care which affects skilled birth attendance. Negative client's experiences at health facilities cause them to delay or avoid seeking care, which highlights services providers should consider and act on the expectations and experiences of women and their families. Though there are few studies conducted in Ethiopia on maternal satisfaction with Labor and Delivery (LAD) services, there is no study conducted in the study area. Therefore the study aims to assess the mother's satisfaction with existing LAD services and associated factors at all levels of health care in the West Shewa zone.

METHODS

An institution-based cross-sectional study was conducted at public health facilities in West Shewa zone, Central Ethiopia. A systematic sampling technique was used to select 560 respondents by using their delivery registration number and data were collected through face to face interview. Mothers were considered satisfied if they responded satisfied/very satisfied with 75% or more of the questions assessing satisfaction. Binary and multivariable logistic regression analysis was used to identify associated factors.

RESULTS

The overall proportion of mothers who were satisfied with the current LAD care services were 60.8%. The main areas of dissatisfaction were; accessibility and cleanness of toilets/shower 72.6%, overall cleanness of the facility/including waiting-area 40.1% and presence of support a person during birth 38.0%. The presence of cultural practices (AOR = 2.5), discussion on the place of delivery with health worker during ANC (AOR = 1.75), providers asks for consent before procedure (AOR = 2.77), encouraging companion to remain with mother (AOR = 2.22), never leave mother alone or unattended (AOR = 2.56), giving periodic updates on status and progress of labor (AOR = 2.04) and explaining what is being done and to expect during LAD (AOR = 2.20) were factors identified to be significantly associated with satisfaction on LAD services.

CONCLUSION

The overall satisfaction of mothers with LAD services at public health facilities in the West-Shewa zone was relatively low. Presence of cultural practices, discussion on the place of delivery, asking for consent before the procedure, encouraging companion to remain with mothers and explaining what is being done were factors identified. Therefore, all stakeholders have to emphatically work on those identified factors to improve mothers' satisfaction with LAD services.

Urinary pathogenic bacterial profile, antibiogram of isolates and associated risk factors among pregnant women in Ambo town, Central Ethiopia: a cross-sectional study

Background

Urinary tract infection (UTI) is a well-known bacterial infection posing serious health problem in pregnant women. A study was conducted in pregnant women with the objectives of estimating prevalence of UTI, determining antibiogram of the bacterial isolates and assessment of the potential risk factors associated with UTI.

Methods

A cross-sectional study design was used to collect 300 mid-stream urine samples from pregnant women from March 2016 to December, 2016. Samples were inoculated into Cysteine Lactose Electrolyte Deficient medium (CLED). Colonies from CLED were subcultured onto MacConkey and Blood agar plates. A standard agar disc diffusion method was used to determine antimicrobial susceptibility. Chi-square (X2) test & logistic regression were used to show associations between UTI and explanatory variables & identify the predictors of UTI, respectively.

Results

The age of pregnant women enrolled in this study ranges from 16 to 46 years (mean ± standard deviation = 25 ± 4.7 years).The overall prevalence of UTI in pregnant women was 18.7% (95% confidence interval [CI]: 14.4-23.54%).The prevalence of symptomatic and asymptomatic UTI was 20.4% (95% CI: 13.09-29.46%) and 17.8% (95% CI: 12.70-23.83%) respectively. The predominant bacteria identified were E. coli (46.4%), S. aureus (14.3%), coagulase negative Staphylococci [CoNS] (14.3%) and Proteus species (10.6%). Majority of Gram-negative bacteria isolates were resistant to ampicillin (70%), ceftriaxon (66%), gentamicin (68%) and nitrofurantoin (64%) while 75-100% of the Gram positive isolates were resistance to ampicillin. Multiple drug resistance was observed in all of the isolates. Multivariable logistic regression revealed that the odds of acquiring UTI was 4.78 times higher in pregnant women earning monthly income of ≤500 Ethiopian Birr (21.18 USD) as compared to those earning monthly income >2001 Ethiopian Birr [84.79 USD] (P = 0.046). Similarly, the risk of UTI was higher in those who eat raw meat (OR = 2.04, 95% CI: 1.09, 3.83, P = 0.026) and had previous UTI history (OR = 2.29, 95% CI = 1.15-4.56, P = 0.019) as compared to those who eat cooked meat and had no previous history of UTI.

Conclusions

The prevalence & antimicrobial resistance of uropathogens was high. Health education, continuous surveillance of UTI and their antimicrobial resistance pattern are essential to reduce the consequence of symptomatic and asymptomatic bacteriuria and multi-drug resistant bacteria in pregnant women.